Group rating “open enrollment”

Here’s what your TPA should be discussing with you:

Group rating this year and group rating next year:

Make sure you get a fresh offer every year, not just a renewal invoice. If you pay the renewal invoice and then decide to go with another group, you have to ask for a refund – and you may not get it all back.

Your TPA should explain why if your company does not get the maximum 53% discount.

The TPA should explain why if it bills you for 24 months of representation when the group only lasts for 12 months.

The BWC deadline to enroll in group rating is mid-November 2015.

Group rating this year and retrospective group rating next year:

If your TPA is recommending retrospective group rating for next year, find out why. If its fees will be higher than when you were in regular group rating, what will it do differently to earn a bigger fee? Request offers from other groups to see if you can continue to get the discount up front.

Make sure you discuss the assessment percentage (10%, 15% or 25%), in case the group performs poorly and you have to pay additional premiums in 3, 4 or 5 years.

The BWC deadline to enroll in retrospective group rating is mid-January 2016.

If your company is in retrospective group rating this year:

Your TPA should tell you if your company would be welcome in group rating with the up-front discount next year. Are there other BWC programs that will reduce premiums without waiting 3, 4 or 5 years for possible rebates as with retrospective group rating?

Make sure you discuss the assessment percentage (10%, 15% or 25%), in case the group performs poorly and you have to pay additional premiums in 3, 4 or 5 years.

The TPA should explain why if it bills you for 24 months of representation when the group only lasts for 12 months.

If your company is not in group rating this year:

Your TPA should tell you if your company would be welcome in group rating next year, and tell you about other BWC programs that could reduce your premiums.

If your company is not welcome in group rating for next year:

Your TPA should tell you exactly why you’re not welcome in group rating, and describe other BWC programs that could reduce your premiums.